Ramblings of an Emergency Physician in Texas

Dr. Charles comments on…the impossible

Well, maybe not impossible, but the wildly hopeful: the elimination of diabetes (per Dr. Charles):

In a discovery that has stunned even those behind it, scientists at a Toronto hospital say they have proof the body’s nervous system helps trigger diabetes, opening the door to a potential near-cure of the disease that affects millions of Canadians.

Diabetic mice became healthy virtually overnight after researchers injected a substance to counteract the effect of malfunctioning pain neurons in the pancreas.

“I couldn’t believe it,” said Dr. Michael Salter, a pain expert at the Hospital for Sick Children and one of the scientists. “Mice with diabetes suddenly didn’t have diabetes any more.”

Read it, and wonder: if this pans out a) what a boon for many medical diseases currently thought of as chronic, and b) neurologists may have a new lease on life medicine.

Comments

Yes, but will the drug companies let the product be developed in the United States? And will the FDA let it happen (and not hold it up for a zillion years.) Because I’m sure the insulin and oral agent companies stand to lose billions, right? All of my patients are wondering if this will end up in a money-snafu. (And they’re all already convinced that the same issue is holding up a cure for cancer.)

What’s going to hold it up is replicating the study, seeing if it applies to humans and developing an effective delivery system, then finally dealing with the FDA. It’s hard to imagine SQ Capsaicin working on diabetes plus it would hurt like a SOB. Injecting Substance P directly into the pancreatic artery would also be difficult from a practical standpoint plus if I read the article right it would have be done every few months otherwise the islet cells poop out again.

Hmm, I’m envisioning clinics springing up to inject capsaicin mixed with lidocaine the same way the chelation therapy clinics did.

Josh, I have a lot of love for neurologists, they’re usually terribly bright. It’d be intesting to see who would be the lead specialty in this; having thought about it for a second, GI would be a good choice, but who knows.

IMO, The study of neurology is fascinating, the practice of it would not be. A lot of problems that you can’t do much about. Spending most of the day adjusting seizure and Parkinson meds would not be all that thrilling. I think that is why a lot of them have jumped all over the TPA-for-stroke bandwagon even though it may only have marginal benefit in a small select group of patients (and perhaps more harm) because they are bored andtired of feeling helpless and want to be able to do something.

A Neurosurgeon once told me that a head CT scan is worth a thousand neurologists.

Thanks guys. The only thing about neurology that would worry me is the idea of all diagnosis no treatment. The only thing I think that would mitigate that to some degree is the future of pharm intervention. If they can find some differences in neurotransmitter receptors that would allow semi-targeted blocking or upregulating in specific brain regions it could go along way. I’m helping out with some research at the moment that studies acetylcholine-receptor protein knockouts and the effects on ethanol and nicotine preference right now on mice. Who knows what the future will bring? The brain is the last frontier, the only place to go with intervention is forward :-)

I don’t know about the CT being worth a thousand neurologists. They help tell the neurosurgeon where to ablate on severe epilepsy patients. They get to work with neuromuscular problems like muscular dystrophy. I don’t think its any more limited than a Nephrologist or a GI doc who’ve shrunk their problems down to one flavor of medicine.

Still I do have a long long time to think about it. Thanks for the opinions guys. I am actually going back to Midland for Christmas, from school in West Virginia so I’ll be back in Grunt Doc’s vaguely defined region of the country soon after Friday’s Hemotology final. I hope y’all have a Merry, and Brown West Texas, Christmas!